When someone is diagnosed with major depressive disorder, there’s usually a 60 percent chance that their condition developed due to environmental factors, and a 40 percent chance that they developed due to genetic factors. People with direct relatives (parents/siblings) with depression are three times as likely to also struggle with depression than the rest of the general population. In other words, yes: there is a strong link between depression and genetics.
But it’s really nowhere near as simple as that. Individuals with several depressed relatives should still consider environmental factors before solely blaming genetics. While genetics very often play a role, depression is a complex mental health issue affected by a wide array of different potential causes. Understanding how and why a depression developed is important for therapeutic reasons.
What is Depression?
For the most part, depression begins because of a combination of external and internal stimuli. The symptoms of depression set it apart from other, ‘normal’ displays of sadness and low mood. It’s perfectly healthy to display discontent and sorrow in appropriate times, especially during moments defined by loss or pain. Feeling bad sometimes is part of the human experience, and not something to be diagnosed as a problem. But there are people – millions of them, in fact – who feel perpetually sad, stuck in a low mood for weeks at a time, often without cause. Symptoms of depression include:
- Being unable or unwilling to get out of bed.
- Struggling immensely to fall asleep.
- Missing work and other responsibilities.
- Losing interest in old hobbies.
- Dodging or avoiding social activities.
- Frequent discussions about/thoughts regarding suicide.
- Self-harm and frequent self-deprecation.
There are many different forms of depression. These forms, or disorders, are used to help patients better understand why they might feel depressed, as per the possible cause of their condition. Those affected by seasonal affective disorder experience depression and other symptoms as a result of the shift in seasons, particularly towards winter time. Those affected by premenstrual dysphoria are likely to experience a sudden downward shift in mood in the week leading up to menstruation.
Depression is also commonly paired with a form of anxiety, including generalized anxiety disorder (GAD) and post-traumatic stress disorder (PTSD). Codependent forms of depression cannot be treated on their own but need to be addressed in conjunction with other issues.
The Depression Gene
While research into the nature of depression is always ongoing, scientists have discovered a gene that appears to be more common in families with a history of recurrent depression. It has been long believed that depression was in some shape or form hereditary, but this gene – the chromosome 3p25-26 – is the first time a gene has been isolated as a factor for depression.
But the depression gene is only one part of a bigger picture. Depression can sometimes run in the family due to similar living conditions. Growing up exposed to certain stressful factors, contrary to popular belief, does not necessarily “toughen up” children but leaves them more likely to struggle with mental health issues.
Problems that can grow from generation to generation such as poverty and poor living conditions are also factors for depression. If a child witnesses adult depressed behavior early on, they may consider it normal, and mirror the behavior of their elders.
Gender seems to play a role. Women are more often depressed than men. This seems to be unaffected by race, culture, or education, with women consistently reporting depression more often than men throughout the world. Younger women in their teens and early twenties are most likely to struggle with depression, even when accounting for potential underreporting.
Treatment for Depression
Treatment for depression depends on why a person is depressed, how depressed they are, and their specific circumstances. Treatments also vary in effectiveness. Medication and therapy are the first line of offense against depression, and they often work to mitigate or even eliminate some symptoms. But these treatments are not always effective.
Alternatives do exist. In line with psychotherapy/talk therapy, many people have successfully mitigated the effects of their diagnosis by taking on certain hobbies or activities, through music therapy, art therapy, or physical exercise. It takes time and the support of a rigid routine and people helping you stick to your treatment to fully benefit for these alternatives. It can be very hard to be passionate about anything early on in depression treatment, but time does make things easier.
On the side of medication, most patients are first prescribed SSRIs when diagnosed with a depressive disorder. However, a doctor’s first choice of brand may not always be the right one. Patients are encouraged to speak about any potential side effects. They are then weaned off the medication and can try a different kind. If, after a certain number of tries, various different classes of antidepressants (including SNRIs, TCAs, MAOIs and more) do not work as they should, then other treatments will be considered.
One treatment that has proven particularly effective for patients with treatment-resistant depression is transcranial magnetic stimulation. A form of neuromodulation, transcranial magnetic stimulation makes use of harmless magnetic waves (the kinds used in magnetic resonance imaging machines) to stimulate specific areas in the brain, causing the activation of certain signals that affect mood and hormone regulation. TMS can be used in several different pathways of the brain to elicit an antidepressant effect. Over half of people who try it find that it works.
Most of the time, effective treatment requires more than one approach. Depression is treated through a multimodal mindset, taking various different treatments into hand, and utilizing them together to mitigate depression, and eventually send it into remission. However, depression can be a disorder that comes back, time and time again – especially in times of severe stress.
Some people are recommended to go through the rest of their lives taking antidepressant drugs or relying on another form of treatment. Meanwhile, it’s important for people with depression to maintain certain healthy habits that keep them happy, including a balanced diet, a good night’s sleep, regular exercise, time spent with others in a non-stress inducing environment, and a rewarding or satisfying line of work.